1. NEONATAL DEATHS IN
ODISHA
DR. SUDHIRA KUMAR PARIDA.

2. DEFINITION
• Deaths occuring during the neonatal period
i.e., within 28 completed days of birth.
• Calculated as no. of neonatal deaths in a given
yr / 1,000 live births in that yr.

3. IMPORTANCE
• Over 2/3rd of IMR &
• ½ of U5MR
• 90% of neonatal deaths-within 1st 14 days of
life
• ½ of neonatal deaths-within 1st 7 days

4. PROBLEM STATEMENT
SRS 2010:
• NNMR- 42 (R-43,U-32)
• Early NNMR-33 (R-35,U-21)
AHS 2011:
• 31(Angul) - 75(Balangir)
NNMR 10-19 20-29 30-39 40-49 50-59 60-69 70-79
No.of - - 17 10 2 - 1
districts:
• In rural areas of districts - significantly higher
than that in urban areas

5. IMR & NNMR
70
60
50
40
9 (14.8% 0f IMR)
30 61
20
33 (54% of IMR: R-55%,
10 U-50%)
0
IMR NNMR
[SRS 2010]

6. U5MR & NNMR
90
80
70
60
50
78
40
30
42 ( 54% of U5MR )
20
10
0
U5MR NNMR
[SRS 2010]

7. CAUSES
D
CONG. 2 NT
%
MALFORMATIONS 2%
8%
Others
11% PREMATURITY & LBW
29%
BIRTH ASPHYXIA & TRAUMA
23%
SEVERE INFECTION
25%

8. NNMR
EARLY NNMR LATE NNMR
• Prematurity & congenital • Infection
anomalies • Diarrhoea
• Asphyxia

9. DETERMINANTS

10. ANC
120%
98
100%
80% 77
58.4
60%
40% 37.5
20%
0%
at least 1 2+ 3+ full
[COVERAGE EVALUATION SURVEY 2009]

11. CONSUMPTION OF IFA DURING
PREGNANCY
%
None
10%
30 days 100 days
16%
47%
31-90 days
27%
[COVERAGE EVALUATION SURVEY 2009]

12. PLACE OF DELIVERY
%
At home
24.5%
Institutional
75.5%
[COVERAGE EVALUATION SURVEY 2009]

13. Duration of stay at health facility
4+ days
8%
3 days
8%
2 days
1 day
12%
44%
1 day
28%
[COVERAGE EVALUATION SURVEY 2009]

14. DELIVERY ATTENDED BY SBA
90
79%
80
70
60
50
40
30 21%
20
10
0
SBA none
[COVERAGE EVALUATION SURVEY 2009]

15. INSTITUTIONAL DELIVERIES & JSY
JSY 60.7 %
Institutional deliveries
75.5 %
0.00% 20.00% 40.00% 60.00% 80.00%
[COVERAGE EVALUATION SURVEY 2009]

16. BF AFTER CHILD BIRTH
70.00%
63.7
60.00%
50.00%
40.00%
30.00% 27.2
20.00%
8.8
10.00%
0.3
0.00%
< 1 hr 1-23 hr ³ 24 hr No BF
[COVERAGE EVALUATION SURVEY 2009]

17. INTERVENTIONS

18. BEFORE PREGNANCY
• Delayed child-bearing
• Well-timed, well-spaced & wanted
pregnancies
• Well- nourished & healthy mother
• Female literacy

19. DURING PREGNANCY(ANC)
• Early registration
• TT
• IFA
• Good diet
• Counseling on birth preparedness & BF
• Identification of major risk factors of
obstructed labor.

20. INTRAPARTUM & IMMEDIATE
NEWBORN CARE
• PROM-Antibiotics
• Complications- EmOBC
• SBA
• 5 ”C’’s
• Prevention of hypothermia
• Early EBF
• Cord & eye care
• Neonatal resuscitation
• Spl. care for LBW

21. EARLY NBC
• EBF
• Temp maintenance
• Optimal cord care & hygiene
• Immunisation
• Care for LBW baby
• Management of sickness

22. LATE NBC
• EBF
• Cord care & hygiene
• Care for LBW baby

23. HEALTH PROGRAMMES
• JSY
• UIP
• IMNCI
• Mamta dibas
• Pustikar dibas
• JSSK
• Mamta scheme
• E-janani

24. PROGRESS
• ASHAs - in 40,000 villages
• 380 JSY Express
• JSY + Mamta dibas : 26 lakh women
• JSSK - 382 health centre
• ASHA Gruha
• Maa gruha - tribal & outreach area
• 1482 MCH centres
• 394 Health centres -24 7
• 56 Blood banks
• 20 Blood preservation centres

25. REFERENCES
• SRS 2010
• AHS 2011
• UNICEF’s Coverage evaluation survey 2009
• PARK’S textbook of preventive & social
medicine. 21st edition
• Textbook of preventive & social medicine :
sunderlal
• RCH module for MO(PHC).